Thursday, September 24, 2009

Natural VBAC Birth Story

My sweet friend Rachael is allowing me to share her amazing birth story with all of you. I hope it will be an encouragement to anyone who reads it. She had a difficult labor, but in the end, she got her Natural VBAC and a healthy baby boy! Enjoy...

Let me just start by saying that this is EXTREMELY long (as you can see)! I am typing this up more for me, but if you want to tough it out and read it THANKS! My mom was so great and wrote down the times things were happening during most of my labor so that is how I was able to be precise with the times that things happened. I have asked my friend and labor and delivery nurse, Abby, to add her thoughts so those are what you see typed in red. Edward added a few thoughts and those are typed in green...everything else is from me. :) I don't feel like I have the right words to express my feelings about this birth and my thankfulness to the Lord and to all involved in making it happen, but I am going to give it my best shot! So….here it goes:

Sunday, September 6, 2009-41 weeks, 1 day
I had a really rough day. I woke up feeling completely discouraged and wanting to stay in the bed. I was weepy, felt miserable, and was really beginning to wonder if I would end up having to be induced. I had such great times with God the week prior to this day and had felt like I completely surrendered control of this situation to Him. It was really hard to leave it there though! I didn't even want to go to church, but made myself and was sooo glad that I did. It was truly refreshing!11pm-I started having some cramps in my back and a few in my stomach that were pretty uncomfortable. I didn’t think it was labor because there had been a few days recently that I felt this same way and I certainly didn't want to be disappointed. I did find myself on my hands and knees doing pelvic tilts and stretching to try to help with the discomfort. I really thought it was most likely due to my sluggish digestive system.
Monday, September 7, 2009-41 weeks, 2 days-LABOR day
1:30am- I told Edward I really needed to go to bed because I was miserable and sleep was the only thing that would help. I was awakened several times during the night with cramps, but I went back to sleep.5am- I could not lay in the bed any longer...I had to get up to move around and help my back feel better. (side note: this had been an issue over the last few weeks of pregnancy...I would wake up in the early am with back cramps, but once I got up and moved around they got better). I decided to get online and look up the signs of early labor. I was still not 100% convinced, but when I went to the bathroom and saw bloody show I got SO excited because I realized this was it! I timed my contractions for the next half hour and they were at 3-4 minutes apart and lasting for around a minute.
6am- I woke Edward up and asked him to continue timing while I got into the bathtub. I HOPED that I was dilated pretty far along and getting in the tub would help me relax and dilate more so I would be 6cm or so when I got to the hospital. Since I was induced with pitocin for my delivery with Josiah and I have heard those contractions are so much stronger, I really didn't know what to expect as far as pain is concerned going into labor on my own. Anyway, Edward kept timing them until 6:30 while I showered and got ready for the hospital. Once we had timed them for an hour and they were 3-4 minutes apart, lasting around a minute each time, I decided it was time to call my sweet friend and L&D nurse, Abby, to see what she thought.
7am- I called Abby and she was excited and advised me to call Dr. Straughn's office. I called Dr. Straughn's office and started crying when the operator told me that Dr. Straughn was the dr on call that day. PRAISE THE LORD! We had been praying that Dr. Straughn would be able to deliver Joseph! A few minutes later Dr. Straughn called. She said she had been wondering when she would hear from me. She was also excited and said she was still at home but was going to get ready and head in to the hospital and she would meet me there. I laid out Josiah's big brother outfit and Edward woke him up. Edward brought Josiah downstairs and told him to open his eyes and look at what he had to wear today. He was SOOO excited when he saw that he was wearing his big brother shirt because he knew it was time to head to the hospital. It was precious! Once Josiah and Edward were ready, we headed to Brookwood. We parked in the parking deck and walked to labor and delivery because I knew the more walking I did the better!
8:30am- We were admitted to l&d by Abby's friend and co-worker, Courtney.
9:15am- Abby & Dr. Straughn arrived. Dr. Straughn checked me and Abby started my i.v. I was a little disappointed that I was only 3cm, but I was excited that I was 100% effaced! YAYYY! I just KNEW we would have this baby by the afternoon. HA! I had been told earlier in my pregnancy that the only thing that was on my birth plan that I couldn't do was have intermittent monitoring. Because I was a VBAC, I would have to have continuous monitoring which was completely okay with me. I knew it would somewhat limit what I could do to manage the pain, but I understood. Well...Dr. Straughn decided to go ahead and let me be monitored intermittently because Joseph was handling the labor so well. I was able to be on the monitor for 30 minutes and off for 30 minutes.
11:22am- Edward, Abby, and I went walking in the halls of l&d. My contractions were pretty uncomfortable at this point and when I would have one, we would stop and they would both rub my back. My sweet husband is so use to me wanting him to apply a lot of pressure when he massages me, but that is not what felt the best during a contraction. I just wanted light touch and lots of counter pressure on my lower back...but no massaging!Throughout my labor I used many different ways to manage my pain...I rocked on the birth ball, I got in the shower on all fours and let the hot water hit my back and run down onto my belly, I leaned up against Edward and let him hold all of my weight, I laid on my side in the bed and had Edward rub my back, I sat on the edge of the bed with one leg dangling down and breathed through them...MANY different ways to manage the pain and ALL of them helped for a certain period of time and then I would need to move on to something else. Since the tub really didn't do too much for me when I was at home and in VERY early labor, I didn't even try it when I was in active labor. It DID really help me relax to get into the shower though so I did that on two or three different occasions. Edward was always so great about helping me in the shower. When he helped me out the last time, I looked at him and said in a calm (but whiny) voice, "I am going to need pain medicine". I think I may have even specifically mentioned an epidural. He gently reminded me that we had decided on no meds and he knew if I did that I would be disappointed once it was all over with....he told me no. To those that do not know my husband well, let me just say that this is SOOO not like Edward. He hates to see me suffer, but I had asked him during my pregnancy to PLEASE tell me no if I asked for an epidural during labor...he was simply doing what I asked. I am SO thankful he stuck to it! There were a few times during my labor that I thought about giving up and I am so thankful for Edward not letting me!
1:35pm- Dr Straughn came in and checked me and I was only 4cm dilated! What a disappointment! Since I was not progressing quickly, she mentioned that we may want to think about either 1) getting a little pitocin to move things along or 2)have my water broken and put an internal monitor on so we could get a better idea of what was going on. I was SO upset by both of these because I had them BOTH with Josiah and ended up with a c-section. Josiah was also born with a sore on his head that required a longer stay in the hospital to get antibiotics and I have always wondered if the sore MAY have been caused from the internal monitor. Anyway, at that point I KNEW if I had to have pitocin I would need an epidural because the pain was already extremely intense...I could not stand for it to be cranked up anymore. I asked Abby what she thought and she mentioned that it concerned her that my contractions were right on top of one another, but I wasn't really dilating...that is what they can see if there are going to be issues with uterine rupture.
I knew when Dr Straughn mentioned “interventions” you would not want them and I was totally fine with that, but shortly after that I could tell by how you were acting that your contractions were right on top of each other and you were not getting a break in between them which concerned me. At that point I suggested that if we were going to do any interventions that it might be beneficial to get your water broken so that we could monitor contractions internally. However, while you and Edward discussed, you laid back down in bed and your contractions seemed to space out a good bit and back into a pattern that I was more comfortable with. I have to be honest too because at this point, I was getting very nervous about whether or not this was going to happen vaginally. I kept thinking if you could just get past 4 cm then I’d feel a lot better about things.
Even though VBAC was my goal and natural followed right behind that, a healthy baby was the #1 priority.
My goal was to provide comfort and help Rachael remain focused on the birth plan in order for her to manage the pain resulting in a desired vaginal birthing experience. When discussing medicine for the pain and breaking her water, I chose not to appeal to her emotions, but rather logic and get her re-focused on the birth plan and why it’s important to her. We carefully discussed the pros & cons of each option presented and by process of elimination agreed upon a little nubain to allow her to relax between contractions which would aid in natural dilation. Edward and I briefly discussed what we should do and at that point I decided to get a half dose of nubain to help me relax between contractions. since my contractions were right on top of one another I wasn't getting a break and I was not able to my mind I was having flashbacks of my labor with Josiah because that is what the last few hours were like with him before I had my c-section. Looking back, that half dose of nubain was one of the best decisions I made during labor! Even though I still felt my contractions and had to work through them just as I was doing before the nubain, I was able to really relax in between them...I got a little break! In fact, I remember sitting on the edge of the bed with my eyes closed feeling like I was half-way sleeping in between was WONDERFUL! I really believe that helped me along in labor.
3:55pm- Dr. Straughn came back in, but she didn't mention anything else about having pit or having my water broken. I hadn't quite made it to 5cm yet when she returned, but I was a "loose 4" and he was at 0 station. I remember thinking about transition and knowing that is the shortest part of labor. In my mind, if I could just make it to 8cm, I was going to make it because I could handle that being so short. I remember at one point asking what else I could take because the nubain wasn't cutting it anymore. Abby told me that I could take Stadol, but I was so close and by the time I got it there would be no point...I wanted to be able to feel to push and not be out of it. I am glad she discouraged me from taking it!
My reason for discouraging you from Stadol is that it is more powerful than nubain and I was worried if you took it you would be so loopy you wouldn’t be in control and you wouldn’t remember the delivery. I think you were also about 7 cm when we had this discussion which is really too close to delivery for IV pain medication.
6pm- When Dr. Straughn came in and checked me, I was 5-6cm/0-+1 and my contractions were lasting 2 minutes8:01pm- At 8pm Abby checked me and I was 6-7cm/+1
It was at this point that I was like “ok this is going to happen for sure! I remember somewhere around this time, maybe earlier, you really got into the “labor trance” where you had your little system/coping techniques down and you were just doing your thing but didn’t seem to be fully present. This is very common for women to get in this kind of “groove” during labor when they figure out what is working for them.
8:12pm- I was standing by the bed and felt something running down my leg. I remember looking down and saying that I thought my water had broken...and it had! WOW! I was so happy that it broke on its own.
9:38pm- Dr Straughn came back in and checked me and I was 7cm/+1. It seems like my water breaking REALLY helped things along10:35pm-Dr. Straughn checked me again and I was ALMOST 8! YAYY! During transition I kept remembering that someone (not sure who, I THINK it was Abby) had told me to pick a point on the wall and make myself open my eyes and focus on that point during each contraction...that really as helpful!
I mentioned this as something that helped me a lot in transition. One of my nurses told me to do it and I made a big difference.
11:35pm-Abby checked me and I was 9cm. I remember her having me push because there was just a little lip on my cervix and I was trying to push through it. Dr. Straughn came in and I was 9 1/2 .
Actually she said you were 9 ½ but we could go ahead and start pushing some because it was so stretchy and you were really feeling the urge to push. After pushing about 30 minutes, I rechecked you and reduced the “anterior lip” easily, that is when your pushing became much more effective. We started pushing around midnight but I didn't reduce the anterior lip until about 12:30.
How incredible to hear that I was complete and could start REALLY pushing! I remember looking at the clock and realizing that Joseph was not going to be born until Tuesday! CRAZY!

Tuesday, September 8, 2009-41 weeks, 3 days-Joseph’s Birthday
I started pushing on all fours and I remember thinking that it was not working. I remember thinking that it didn’t seem very effective either. But I wanted you to try several different positions and see what worked best for you. I knew you wanted to avoid delivering in lithotomy position if possible. I thought that I would be really disappointed if I had gone through all of this pain and still ended up with another c-section. Right after that thought, Edward leaned over and whispered some scriptures in my ear which is REALLY what I needed to hear then. I remember him reminding me that I could do all things through Christ who strengthens me and that with God ALL things are possible. Just what I needed to hear to spur me on in my pushing! :) I remember it was suggested that I try a different position for pushing and I am SO thankful that was suggested because I don't really think pushing on all fours was doing anything for me.
Abby and April (another WONDERFUL l&D nurse) set the squatting bar up on the bed and I tried pushing on that.
I was so grateful for April’s help at that point because I was getting really tired and I felt like I’d used up my bag of tricks to help you! She is a great nurse for natural labor. It’s always good to have several different people helping that way you get lots of different ideas and techniques and everyone can rotate to stay somewhat fresh. That is when I really began to feel like I was actually doing something. I did that for a little while and then I laid back a little and they put my legs up in stir-ups for a little while...that was REALLY working!
I knew you didn’t want to delivery in lithotomy position, but you were pushing so much more effectively this way and it also allowed you to rest more in between contractions. ***She'd been in labor for a full 24 hours at this point with hardly anything to eat or much sleep.
I think I got on the squat bar one more time and then ended up back in the stir-ups. They pulled out the mirror and that was SO encouraging!
I knew you’d be encouraged to see how far you had come!
I had said that I did not want to have the mirror because I had seen pictures in the Bradley books and I did NOT want to see myself in that state. Well...I am SO happy that I had the mirror because I could see that my pushing was effective. I do remember seeing a bulge, but I was not thinking of how I looked, I was just thinking that I was going to tear BIG time (thank God I did NOT)! At that point I did not care though...I just wanted to get Joseph out.Abby told me that I could rest through a few contractions...that I didn't have to push through every one, but I felt like I had to just keep pushing.
You were so exhausted at this point, so I encouraged you to just push gently and do what your body told you to but not put 100% into it, just so you could gain some strength back for the actual delivery.
I remember not really knowing when I was having a contraction because I couldn't feel them any longer, I just felt sooo much pressure and I HAD to push. I never imagined that the need to deliver my baby would feel the way that it did. As I was pushing, everyone was racing around the room getting everything prepared. My adrenaline was PUMPING as I realized this was REALLY going to happen...I was REALLY going to birth this baby vaginally!I felt like screaming helped me push better, so...I screamed with every push. I didn't scream because it hurt (I really don't remember it being painful at this point). When I started seeing Joseph's little head, I remember thinking that Josiah was going to miss it. Josiah had asked us earlier on during my pregnancy if he could be there when Joseph was born. At first I said no, but when we started thinking about it, praying about it, and talking about it...we decided to let him come into the room when I got ready to birth his brother. So...I told my mom to please go get him and she did. Josiah came back in when Dr. Straughn had made it into the room and I was pushing Joseph out. :) I will post about that another time. :) I remember seeing Joseph's head really start to come out and from that point on, I was not watching anymore because I was focused on pushing him out...I do hope I can watch everything next time though. Once I had pushed his head out, Abby looked at me in my eyes and very seriously told me that I was going to have to push as hard as I could RIGHT THEN....
When his head came out, I knew he was a BIG BOY and his shoulders weren’t going to just slip out easily, so I wanted you to know that you had to get this boy out and use all your strength to do it.
I knew by the look on her face that I HAD to push with all of my strength at that moment...and that is when my sweet boy was born!I was completely in awe when he was put on my chest...I could not believe that I had birthed this baby vaginally...and he was SO BIG! When he was weighed I could hardly believe that he was nearly 9 pounds...WOW! It seemed like the last few hours of labor passed by so quickly. Even though it was really hard, it did not at all seem like I Was laboring for as long as I was. If I had known exactly how long I would have been in labor I would not have been up for the challenge...THANK GOD I had no clue! I was sooo proud that I had actually done was so empowering! Joseph wasn't crying when he was placed on my chest so the nurses had to take him to the side and do a deep suction on him.
He was having a little trouble getting his color and breathing (grunting/retracting) so we gave him a minute after the cord was cut, but then April and I both knew he needed a little stimulation and free flow o2 and we called transition nursery (we call them when we feel babies need to be looked at a little closer by a NICU nurse) to come look at him after he was still having trouble at 6 minutes I think. He must’ve taken a big gulp on the way out because they did an OG tube and got out somewhere between 5 and 7 cc’s of fluid off his tummy.
Even though I had a long labor and delivery, he had a lot of fluid on his lungs and I had a lot of bleeding (even though I didn't realize it then). I did get to hold him again and try to nurse him, but he was so sleepy and not wanting to latch on. I was shaking because I was FREEZING afterwards and I was SOOO thirsty! We stayed in recovery for a while so he could try to eat and all of my family that was present could come in and meet Joseph. I was able to get up and walk to the bathroom during this time. When it was time to go up to our room, it was SO nice to be wheeled in a wheelchair rather than taken up on a stretcher.This experience was so amazing and I really thank God for answering our prayers! I have had the desire to have a birth just like this before I ever became pregnant with Josiah. Josiah's birth was so precious to me because he made me a mom and I am so thankful that I have a healthy boy even though things didn't go the way that I planned or desired them to go. Joseph's birth was the manifestation of the deepest longings of my heart in regards to childbirth and that is so incredible to me. This truly feels like the biggest accomplishment I have ever made in my life! I will most definitely go this route again with any other children God blesses our family with...every second of waiting, pain, and pressure was SO worth this incredible little boy that I am holding in my arms now! God is so good to us and I give Him 100% of the glory for answering our prayers and giving me what I needed to birth our sweet Samuel Joseph!
It really was such an honor to help you through this beautiful labor and delivery experience. I was so overjoyed that God blessed you with your heart’s desire! Your labor was probably one of the most difficult natural labors that I’ve ever witnessed. You were really hurting even early on and then it was so long, truly a marathon. I know that if you can make it through that labor, any other labor will be a piece of cake!

1 comment:

  1. You are such a wonderful nurse and a great friend! I could not have asked for a better L&d nurse for this birth!!! Thanks for all that you do. I hope we're both still in B'ham for my next birth so we can do this again...only a lot less time involved next go round! :)